located in Johannesburg North is looking for a Clinical Auditor to join their team Minimum Education: nurse) Minimum Experience: 3 to 5 years (previous clinical auditing experience in a managed healthcare environment accounts under the guidance of the gazette Use clinical guidelines and protocols when vetting accounts accounts payment Schedule the weekly roster for the clinical auditors Work with other healthcare personnel personnel within the organisation Provide clinical expertise within the organisation where required Negotiation
/>Minimum Experience: 3 to 5 years (previous clinical auditing experience in a managed healthcare environment under the guidance of the gazette
located in Johannesburg North is looking for a Clinical Auditor to join their team Minimum Education: nurse) Minimum Experience: 3 to 5 years (previous clinical auditing experience in a managed healthcare environment accounts under the guidance of the gazette Use clinical guidelines and protocols when vetting accounts accounts payment Schedule the weekly roster for the clinical auditors Work with other healthcare personnel personnel within the organisation Provide clinical expertise within the organisation where required Negotiation
nursing experience.
medical insurance space is seeking a Medical Claims Clinical Auditor to join their team based in Port Elizabeth hospital nursing experience. Previous exposure to clinical auditing is highly advantageous. Be available Responsibilities Internal Process: Apply scheme rules, clinical policies and protocols to funding. Action allocated case managers for resolution. Act as clinical support to non-clinical hospital claim auditors in terms of of hospital tariff applications and clinical guidance (e.g. procedures, devices and drug utilization)
Clinical Risk Management Specialist Industry: Insurance Location: Cape Town Type: Hybrid (3 In/ 2 Out) seeks to employ a Clinically qualified individual to assist within their Clinical Risk Management team with clients to address risk profiles. Provide clinical leadership and support. Analyze research data the relevant council. Proven underwriting and clinical risk management working experience within Managed
Clinical Risk Management Specialist Industry: Insurance Location: Cape Town Type: Hybrid (3 In/ 2 Out) seeks to employ a Clinically qualified individual to assist within their Clinical Risk Management team with clients to address risk profiles. Provide clinical leadership and support. Analyze research data the relevant council. Proven underwriting and clinical risk management working experience within Managed
medical insurance space is seeking a Medical Claims Clinical Auditor to join their team based in Port Elizabeth hospital nursing experience. Previous exposure to clinical auditing is highly advantageous. Be available Responsibilities Internal Process: Apply scheme rules, clinical policies and protocols to funding. Action allocated case managers for resolution. Act as clinical support to non-clinical hospital claim auditors in terms of of hospital tariff applications and clinical guidance (e.g. procedures, devices and drug utilization)
accounts. Reconciliations Daily reconciliation of all clinic receipts/banking (cash, yoco and medical aid receipts) reconciliations of pharmacy inventory for all clinics (inventory receipts, issues, and balances.) Weekly and allocations. Compile weekly report for each clinic on claim status. Weekly follow-up on medical aid
accounts. Reconciliations Daily reconciliation of all clinic receipts/banking (cash, yoco and medical aid receipts) reconciliations of pharmacy inventory for all clinics (inventory receipts, issues, and balances.) Weekly and allocations. Compile weekly report for each clinic on claim status. Weekly follow-up on medical aid